Shadia Rask

The ethnic gap in mental health: A population-based study of Russian, Somali and Kurdish origin migrants in Finland

Aims: Research demonstrates that migrants are more vulnerable to poor mental health than general populations, but population-based studies with distinct migrant groups are scarce. We aim to (1) assess the prevalence of mental health symptoms in Russian, Somali and Kurdish origin migrants in Finland; (2) compare the prevalence of mental health symptoms in these migrant groups to the Finnish population; (3) determine which socio-demographic factors are associated with mental health symptoms. Methods: We used data from the Finnish Migrant Health and Wellbeing Study and Health 2011 Survey. Depressive and anxiety symptoms were measured using the Hopkins Symptom Checklist-25 (HSCL-25), and 1.75 was used as cut-off for clinically significant symptoms. Somatization was measured using the Symptom Checklist-90 (SCL-90) somatization scale. The age-adjusted prevalence of mental health symptoms in the studied groups was calculated by gender using predicted margins. Logistic regression analysis was used to determine which socio-demographic factors are associated with mental health symptoms in the studied population groups. Results: The prevalence of depressive and anxiety symptoms was higher in Russian women (24%) and Kurdish men (23%) and women (49%) than in the Finnish population (9–10%). These differences were statistically significant (p <.001). Socioeconomic disadvantage (e.g. unemployment and poor economic situation) and migration-related factors (e.g. poor language proficiency and short time since migration) significantly increased the odds for depressive and anxiety symptoms. Conclusions: Mental health symptoms are highly prevalent particularly in Kurdish migrants in Finland. Holistic interventions and co-operation between integration and mental health services are acutely needed.

The association between discrimination and psychological and social well-being: a population-based study of Russian, Somali and Kurdish migrants in Finland

Background Discrimination is known to negatively affect the psychological well-being of migrants. Less is known on the association between discrimination and social well-being. Aim We examined the association between experienced discrimination and psychological (mental health, quality of life) and social well-being (loneliness, feelings of safety, trust towards society) in Russian, Somali and Kurdish migrants in Finland. Methods We used data from the Finnish Migrant Health and Wellbeing Study (Maamu). The participants comprised 1795 persons of Russian, Somali or Kurdish origin aged 18–64 years. Experiences of discrimination, loneliness, safety and trust towards society were measured using interview questions. Mental health symptoms were measured using the HSCL-25 and quality of life using EUROHIS-QOL. Logistic regression analyses were conducted to investigate the associations between discrimination and psychological and social well-being, separately for the three ethnic groups. Results Discrimination increased the odds for mental health symptoms and decreased the odds for quality of life among Russian and Kurdish migrants, but not Somalis. Discrimination was associated with feeling unsafe and decreased trust towards society among all migrants. Among Kurds, discrimination increased the odds also for loneliness. Conclusions Discrimination is an essential threat to the psychological and social well-being of Russian, Somali or Kurdish migrants.

Construct validity of the HSCL-25 and SCL-90-Somatization scales among Russian, Somali and Kurdish origin migrants in Finland

ABSTRACT One of the most fundamental issues in psychiatric assessment across different sociocultural and linguistic groups is assuring test reliability and validity. We analyze the construct validity of the HSCL-25 depression and anxiety scales and the SCL-90-Somatization scale in a population-based study (Finnish Migrant Health and Wellbeing Study) among 1356 Russian, Somali and Kurdish origin migrants (aged 18–64 years old) in Finland using an Exploratory Structural Equation Modelling approach. The results revealed problems in establishing measurement invariance of the HSCL-25 depression and anxiety and SCL-90-Somatization scales. Two types of exploratory analysis (Exploratory Factor Analysis and Network Analysis) confirmed the mismatch between the theoretical structure and the data set. In addition, there were considerable group differences between the Russian, Somali and Kurdish groups, with the Somali group in particular showing differing results. The results are discussed in relation to sociocultural variation in manifesting psychological distress and psychiatric assessment in multicultural settings.

The association between discrimination and health: findings on Russian, Somali and Kurdish origin populations in Finland

Background The Second European Union Minorities and Discrimination Survey recently demonstrated widespread discrimination across EU countries, with high discrimination rates observed in countries like Finland. Discrimination is known to negatively impact health, but fewer studies have examined how different types of perceived discrimination are related to health. Methods This study examines (i) the prevalence of different types of perceived discrimination among Russian, Somali and Kurdish origin populations in Finland, and (ii) the association between different types of perceived discrimination (no experiences; subtle discrimination only; overt or subtle and overt discrimination) and health (self-rated health; limiting long-term illness (LLTI) or disability; mental health symptoms). Data are from the Finnish Migrant Health and Wellbeing Study (n = 1795). Subtle discrimination implies reporting being treated with less courtesy and/or treated with less respect than others, and overt discrimination being called names or insulted and/or threatened or harassed. The prevalence of discrimination and the associations between discrimination and health were calculated with predicted margins and logistic regression. Results Experiences of subtle discrimination were more common than overt discrimination in all the studied groups. Subtle discrimination was reported by 29% of Somali origin persons and 35% Russian and Kurdish origin persons. The prevalence of overt discrimination ranged between 22% and 24%. Experiences of discrimination increased the odds for poor self-reported health, LLTI and mental health symptoms, particularly among those reporting subtle discrimination only. Conclusions To promote the health of diverse populations, actions against racism and discrimination are highly needed, including initiatives that promote shared belonging.